'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

Report castigates GPs for COPD care

A damning report by the British Lung Foundation has revealed patients with chronic obstructive pulmonary disease spend much of their time in hospital or recuperating at home because they are not identified early enough by their GP.

The survey of 1,400 patients, conducted this year and published last week, showed 27 per cent had spent a week or more in hospital in the last 12 months.

Some 44 per cent reported spending at least a month at home in the previous year recuperating from an exacerbation and 25 per cent said they were housebound for three months or more.

Dr Antony Crockett, a GP in Swindon who is involved in an outcomes audit with the British Thoracic Society COPD Consortium, said more than half of GPs were confused about which treatment to use.

He added 20 times more people died from COPD than asthma and only about 25 per cent of COPD cases were actually diagnosed.

Dr Crockett, a member of the General Practice Airways Group, said the cash available through the quality and outcomes framework of the new contract would help GPs focus their efforts on COPD. 'We can do a great deal for these patients. One of the major aims of COPD management is to reduce exacerbations.'